The controlling opinion, written by Chief Justice John Roberts, upheld the mandate as a tax, although concluded it was not valid as an exercise of Congress’ commerce clause power. Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan joined in the outcome.

The decision in National Federation of Independent Business v. Sebelius comes as something of a surprise after the generally hostile reception the law received during the six hours of oral arguments held over three days in March. But by siding with the court’s four Democratic appointees, Chief Justice Roberts avoided the delegitimizing taint of politics that surrounds a party-line vote while passing Obamacare’s fate back to the elected branches. GOP candidates and incumbents will surely spend the rest of the 2012 campaign season running against the Supreme Court and for repeal of the law.

Five justices concluded that the mandate, which requires virtually all Americans to obtain minimum health insurance coverage or pay a penalty, falls within Congress’ power under the Constitution to “lay and collect taxes.”

“The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause,” Roberts wrote. “That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it. In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance. Such legislation is within Congress’s power to tax.”

Ginsburg, writing separately for the four liberals, said they would have upheld the mandate under the commerce clause too. “Unlike the market for almost any other product or service, the market for medical care is one in which all individuals inevitably participate,” she wrote. “Virtually every person residing in the United States, sooner or later, will visit a doctor or other health care professional.”

He said, “So Miss Fluke, and the rest of you feminazis, here’s the deal. If we are going to pay for your contraceptives, and thus pay for you to have sex, we want something for it. We want you post the videos online so we can all watch.”

He also called Fluke a “slut” and a prostitute after she argued that birth control should be covered by health insurance at religious institutions.

The Washington Post’s Melinda Henneberger argued in an earlier piece that Fluke may not have been the best witness for a very different reason: As a student, rather than an employee, of Georgetown, her insurance coverage would not change one way or the other under the Affordable Care Act as currently written, with or without a religious exemption to institutions like the Jesuit school Fluke attends.

So Rep. Paul Ryan, the Wisconsin Republican who best exemplifies the soulless Randroid bean-counting dweeb demographic, has decided to release his plan to “reform” entitlements this week. As you can imagine, it completely sucks:

Ryan also said that he would propose changing Medicare, the popular health program for seniors, into what he called a “premium support plan” similar to the Medicare prescription drug program. […]

Seniors would be able to pick from a list of private plans competing for their business, Ryan said. Seniors would pick the plan of their choosing, and Medicare would subsidize that coverage.

Children, let’s stop and think about this for a moment.

Do you know why Medicare was established in the first place? That’s right — because retirees had difficulty getting affordable health insurance due to their higher medical liabilities. And of course, even those who could afford such insurance would find their policies rescinded if their care got too expensive — in essence, a private-sector death panel.

So we created Medicare! And it has been one of the most successful government programs of the past century, helping countless seniors get quality care without putting themselves into bankruptcy paying for private insurance. And now Paul Ryan wants to turn it into another corporate welfare scam.

The current Medicare program would be dissolved and the next generation of seniors would choose from Medicare-certified private plans on an exchange. But that wouldn’t save money. In fact, it would cost money. As the Congressional Budget Office has said (pdf), since Medicare is cheaper than private insurance, beneficiaries will see “higher premiums in the private market for a package of benefits similar to that currently provided by Medicare.” […]

In both cases, what saves money is not the reform. It’s the cut. For Medicare, the cut is that the government wouldn’t cover the full cost of the private Medicare plans, and the portion they would cover is set to shrink as time goes on.

Hear that, Granny? Your health care is about to be sacrificed at the altar of Aetna and Cigna! I hope you like it!

I’m not always a fan of AARP (they do provide affordable insurance to people who otherwise couldn’t get it). They did a lot of work to push the Affordable Care Act, and they stand up for consumers on a wide variety of issues.

Bottom line? Even if I didn’t like them at all, the fact that the Republicans have targeted them would make me want to defend them. After all, sometimes the enemy of my enemy is my friend!

Newly empowered House Republicans are getting ready to renew their attacks against AARP over its support for the healthcare reform law, The Hill has learned.

The Ways and Means health and oversight subcommittees are hauling in the seniors lobby’s executives before the panel for an April 1 hearing on how the group stands to benefit from the law, among other topics. Republicans say AARP supported the law’s $200 billion in cuts to the Medicare Advantage program because it stands to gain financially as seniors replace their MA plans with Medicare supplemental insurance — or Medigap — policies endorsed by the association.

The hearing will cover not only Medigap but “AARP’s organizational structure, management, and financial growth over the last decade.”

An embarrassing hearing would not only hit AARP back for its support of the law, but fits in with the GOP’s mantra that the law was written behind closed doors to favor Democratic allies. And policy-wise, it could empower Republicans to tackle Medigap policies, which many conservatives want to reform because they believe they contribute to over-utilization of the medical system by reducing out-of-pocket contributions.

Imagine the nerve of old people actually going to the doctor’s, taking care of their health and extending their lifespan. Shame on them!

PEORIA, Arizona (Reuters) – A pacemaker and defibrillator fitted to carpenter Douglas Gravagna’s failing heart makes even rising from the couch of his Phoenix-valley home a battle.

But it is not congestive heart failure that is killing him, he says. It is a decision by Arizona Governor Jan Brewer to stop funding for some organ transplants as the state struggles to reduce a yawning budget deficit.

“She’s signing death warrants — that’s what she’s doing. This is death for me,” says Gravagna, 44, a heavy-set man who takes 14 medications to stay alive.

Gravagna is among 98 people denied state Medicaid funding for potentially life-saving transplants and at the forefront of a harrowing battle over the state’s public finances.

The measure enacted last October by Brewer trimmed spending on Medicaid, the federal-state health insurance program, to help close a projected 2012 budget deficit of $1.15 billion.

It eliminated coverage for transplants including lung, heart, liver and bone marrow after weighing the success and survival rates for certain transplant procedures.

Question for the tea party and everyone who voted for tea party Republicans in November: Did you enjoy your purely cosmetic vote to repeal the health care reform law? Personally, I would feel pandered to, and not particularly satisfied with all of that fiscally expensive congressional time being wasted on a vote that meant absolutely nothing. But that’s me.

I mean, you and your peers are obsessively focused on budget deficits and the national debt. Perhaps all of that federal money, all of that federal time and all of those federal resources would have been more effectively spent on something that had a chance of actually happening. Instead, you mandated that your Republican members of the House spend countless dollars on a symbolic exercise in, well, hooey. Nonsense. The political equivalent of pissing into the wind.

Considering that many of us on the progressive side of the political divide supported the health care law in part because it actually reduces the deficit, and considering that many of us on the progressive side of the political divide supported the stimulus and, within it, the largest middle class tax cut in American history, I’m getting a strong idea as to who is more interested in fiscal discipline and who isn’t.

With this meaningless vote, not only have the Republicans proved themselves to be entirely disinterested in reducing the deficit, but they’ve also reinforced their obsession with bumper sticker slogans, self-contradictions and utterly nonsensical political gestures.

Here are two more fantastic examples of how Republicans seriously dislike health care reform, socialized medicine and “government-run” healthcare — that is, until they actually need it.

You may or may not recall a study conducted before the health care reform law was passed by the office of Rep. Anthony Weiner. At the time, 55 Republican members of Congress were enrolled in Medicare, including Senators McCain, McConnell, Kyl, Shelby, Lugar, Inhofe and Grassley. All of whom were opposed to the public option and health care reform.

On the House side, Rep. Weiner’s list includes Peter King, Phil Gingrey, wingnut Virginia Foxx and the godfather of the tea party movement Ron Paul. Seriously, Ron Paul! All 55 members are accepting a form of the public option. Government-run health care. Socialized medicine. I wonder what Ayn Rand would say about Ron Paul accepting Medicare? A program that, more than anything else, will help to bump the national debt from 15 percent of GDP to 35 percent of GDP by 2082. And they claim to be worried about the debt? That’s rich.

Where are the tea party budget hawks — the tri-corned hat reenactors with their misspelled signs and racist voodoo portraits of the president — screeching for Ron Paul to give up his share in American socialism?

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